Explain how can healthcare service providers avoid claims, Operation Management

Assignment Help:

Part I: Avoid claims rejections

A payer may delay or deny payment because of inaccurate or missing information in a submitted claim. Many contracts require payment within a specified period of time, for example, 30 days from submission of a "clean claim." How can healthcare service providers avoid claims rejections?

Part II: Ensure payment

The Medicare intermediary has returned a claim to a hospital because of an invalid diagnosis code (OCE-Outpatient Code Edit violation number one). This implies that the procedure performed is not supported by the diagnosis code. What action can the provider take to ensure payment?


Related Discussions:- Explain how can healthcare service providers avoid claims

Explain forecast week 7 using a six-week moving average, Weekly sales of ry...

Weekly sales of rye bread at the corner store are shown below. Using this data, forecast Week 7 using a six-week moving average. Week Sales 1 415 2 389 3 420 4 382 5

Describe the differences between a 3rd party beneficiary, Explain the diffe...

Explain the differences between a 3rd party beneficiary and a 3rd party assignee. Why are assignments of contracts so important for our free enterprise economy?

Case study...distribution problem at rollerblade, what is the problem that ...

what is the problem that you can understand by reading the above situation? how appropriate might a just in time inventory system be for product such as roller skates

Explain different levels of diversification firms, What are the different l...

What are the different levels of diversification firms can purpsue by using different corporate level strategies and what are the advantages to diversifying their operations?

Explain what does the supervisor need to be most careful, What does the sup...

What does the supervisor need to be most careful of in following up on delegation? Why?

Explain foreign domestic investment confidence index, How is foreign domest...

How is foreign domestic investment confidence index useful to businesses?

Explain manager of a production department, Suppose that you are the manage...

Suppose that you are the manager of a production department that uses 400 boxes of rivets per year. The supplier quotes you a price of $8.50 per box for an order size of 199 boxes

How to promote a business senior village, Have to set up a Blog for the my ...

Have to set up a Blog for the my inanganiry business, The Business is called "Senior Village" its a whole city in a gated community, the Seniors will not have to leave the grounds

Explain utilitarian and a libertarian view, Compare a Utilitarian and a Lib...

Compare a Utilitarian and a Libertarian view on the importance and enforcement of consumer rights (to choose, to safety, to be informed, to be heard, to redress and to privacy).

Explain what is the resulting productivity ratio, The total output from a p...

The total output from a production system in one day is 900 units and the total labor necessary to produce the 900 units is 900 hours. Using the appropriate productivity measure, w

Write Your Message!

Captcha
Free Assignment Quote

Assured A++ Grade

Get guaranteed satisfaction & time on delivery in every assignment order you paid with us! We ensure premium quality solution document along with free turntin report!

All rights reserved! Copyrights ©2019-2020 ExpertsMind IT Educational Pvt Ltd